Apparent Diffusion Coefficient of Glial Neoplasms: Correlation with Fluorodeoxyglucose–Positron-Emission Tomography and Gadolinium-Enhanced MR Imaging

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Fig 1.
A 49-year-old man with an anaplastic astrocytoma. The PET scan (A) demonstrates a C-shaped area of increased radiopharmaceutical uptake (arrow), which exquisitely matches the area of restricted diffusion on the ADC map (arrow, B). C, The correspondence between the FDG-PET scan and the ADC map is better than that in the gadolinium-enhanced MR image (C).
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Fig 2.
A 20-year-old woman with an anaplastic astrocytoma. The area of FDG-PET (arrow, A) uptake closely matches the area of restricted diffusion on the ADC map (arrow, B). This area only shows subtle enhancement (C). The area of bright enhancement does not correlate with either increased FDG-PET uptake or restricted diffusion.
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Fig 3.
Top, Survival curves for the 10 patients with restricted diffusion on ADC maps and for the 11 patients without restricted diffusion on ADC maps, P < .0001. Middle, Survival curves for the 11 patients with increased FDG uptake on PET and the 10 patients with no increased FDG uptake on PET, P = .0004. Bottom, Survival curves for the 10 patients with gadolinium enhancement and the 11 patients without gadolinium enhancement.

Table 1:

Patient population

Patient	Tumor	Age (yr)	Sex	Survival from Date of
Patient	Tumor	Age (yr)	Sex	Diagnosis	Imaging
1	GBM	31	M	10 m 26 d	11 m 5 d
2	GBM	36	F	11 m 13 d	10 m 19 d
3	GBM	49	M	6 m 12 d	7 m 2 d
4	GBM	56	F	12 m 8 d	6 m 20 d
5	GBM	56	M	29 m 19 d	15 m 19 d
6	AA	20	F	35 m 6 d	25 d
7	AA	50	F	17 m 3 d	5 m 22 d
8	AA	49	M	10 m 30 d	7 m 25 d
9	AA	45	M	7 m 15 d	9 m 7 d
10	AA	51	F	21 m	6 m 18 d
11	AODG	43	M	81 m 14 d	65 m 11 d
12	AODG	41	M	63 m 6 d	41 m 10 d
13	LGA	51	F	>76 m	>75 m
14	LGA	35	F	53 m 17 d	39 m 16 d
15	LGA	49	M	>157 m	>86 m
16	LGA	54	M	>127 m	>78 m
17	LGA	79	F	>105 m	>74 m
18	LGODG	42	F	50 m 14 d	49 m 1 d
19	LGODG	34	F	125 m 5 d	25 m 11 d
20	LGODG	47	M	21 m 15 d	15 m 4 d
21	LGA	45	M	48 m 14 d	40 m 9 d

Table 2:

Summary of imaging results and overlap^a

Patient	PET	ADC	Gd	1	2	3	4	5	6	R Value
Patient	PET	ADC	Gd	A ∩ F / A	A ∩ F / F	A ∩ F / AF	G ∩ F / G	G ∩ F / F	G ∩ F / GF	R Value
1	+	+	+	58.1	81	51.2	15.5	69.5	14.5	0.369
2	+	+	+	58.8	34.5	48.7	41.8	80	37.9	−0.629
3	+	+	+	63.6	56.2	42.5	30.7	66.7	26.6	−0.66
4	+	+	+	85	71.8	64	82.3	60.3	53.4	−0.686
5	+	+	–	55.8	71.4	45.7	–	–	–	−0.125
6	+	+	+	72.6	76.3	59.4	46.7	83.8	42.9	−0.722
7	+	+	+	88	73	66.8	74.1	78.7	61.8	−0.451
8	+	+	+	84	81.5	70.8	87	75.1	67.5	−0.207
9	+	+	+	46.8	40.6	27.7	44.1	72.7	37.8	−0.28
10	+	+	+	54.6	74.8	46.1	31.6	48.7	23.8	−0.38
11	–	–	–	–	–	–	–	–	–	−0.222
12	+	–	+	–	–	–	38	44.9	25.9	−0.044
13	–	–	–	–	–	–	–	–	–	0.59
14	–	–	–	–	–	–	–	–	–	0.015
15	–	–	–	–	–	–	–	–	–	−0.569
16	–	–	–	–	–	–	–	–	–	−0.0569
17	–	–	–	–	–	–	–	–	–	−0.611
18	–	–	–	–	–	–	–	–	–	0.201
19	–	–	–	–	–	–	–	–	–	−0.319
20	–	–	–	–	–	–	–	–	–	−0.006
21	–	–	–	–	–	–	–	–	–	−0.469

a + indicates subjective evaluation of positive findings on imaging; –, no findings on imaging. See ″Materials and Methods″ for further explanation of Table values and their derivation.